微型钢板与克氏针内固定治疗掌指骨开放性骨折的临床疗效比较

Comparison of clinical effects of mini-plate and Kirschner wire internal fixation for open metacarpal and phalangeal fractures

目的探讨微型钢板与克氏针内固定治疗掌指骨开放性骨折的临床疗效。方法选取2016年2月至2018年6月本院住院手术治疗的60例掌指骨开放性骨折患者,按随机数表法分为对照组(n=30)和观察组(n=30)。对照组选用克氏针内固定术治疗,观察组选择微型钢板内固定治疗,比较两组手术相关指标,术后3周、6个月、1年掌指功能恢复情况及并发症发生情况。结果观察组患者手术时间、术中出血量、住院时间及术后(6个月、1年)掌指功能评分均高于对照组,差异有统计学意义(P<0.05);两组术后3周掌指功能及并发症发生率比较差异无统计学意义。结论采用微型钢板与克氏针内固定治疗掌指骨开放性骨折的临床效果具有各自优缺点,微型钢板内固定治疗具有较好的稳定性,术后掌骨功能恢复较好,但创伤较克氏针内固定手术大,两者术后并发症发生情况无差异,临床可根据患者具体情况决定最适宜的手术方式。

Objective To explore the clinical effect of internal fixation with microplate and Kirschner wire for open metacarpal and phalangeal fractures. Methods 60 patients with open metacarpal and phalangeal open fractures in our hospital from February 2016 to June 2018 were selected and they were divided into control group(n=30) and observation group(n=30) according to the random number table method. The control group was treated with Kirschner wire internal fixation, and the observation group was selected with mini-plate internal fixation. The operation-related indexes of the two groups and the recovery of palm function of the two groups after 3 weeks, half a year, and 1 year were compared, and count the patient’ s complications. Results The operation time, intraoperative blood loss, hospitalization time and postoperative(half year and one year) palm function scores in the observation group were higher than the control group, the difference was statistically significant(P<0.05). There was no statistically significant difference in palmar function and complication rate 3 weeks after surgery. Conclusion The clinical effects of using microplate and Kirschner wire internal fixation for open metacarpal and phalangeal fractures have their own advantages and disadvantages. Microplate internal fixation treatment has better stability and better recovery of metacarpal function after surgery, but the trauma is better than Kirschner wire Internal fixation surgery is large, and there is no difference in postoperative complications between the two groups. The most appropriate surgical method can be decided clinically according to the specific situation of the patient.